Association of Extensive Video Gaming and Cognitive Function Changes in Brain-Imaging Studies of Pro Gamers and Individuals With Gaming Disorder: Systematic Literature Review

Abstract

Background The World Health Organization announced the inclusion of gaming disorder (GD) in the International Classification of Diseases, 11th Revision, despite some concerns. However, video gaming has been associated with the enhancement of cognitive function. Moreover, despite comparable extensive video gaming, pro gamers have not shown any of the negative symptoms that individuals with GD have reported. It is important to understand the association between extensive video gaming and alterations in brain regions more objectively. Objective This study aimed to systematically explore the association between extensive video gaming and changes in cognitive function by focusing on pro gamers and individuals with GD. Methods Studies about pro gamers and individuals with GD were searched for in the PubMed and Web of Science databases using relevant search terms, for example, “pro-gamers” and “(Internet) gaming disorder.” While studies for pro gamers were searched for without date restrictions, only studies published since 2013 about individuals with GD were included in search results. Article selection was conducted by following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Results By following the PRISMA guidelines, 1903 records with unique titles were identified. Through the screening process of titles and abstracts, 86 full-text articles were accessed to determine their eligibility. A total of 18 studies were included in this systematic review. Among the included 18 studies, six studies included pro gamers as participants, one study included both pro gamers and individuals with GD, and 11 studies included individuals with GD. Pro gamers showed structural and functional alterations in brain regions (eg, the left cingulate cortex, the insula subregions, and the prefrontal regions). Cognitive function (eg, attention and sensorimotor function) and cognitive control improved in pro gamers. Individuals with GD showed structural and functional alterations in brain regions (eg, the striatum, the orbitofrontal cortex, and the amygdala) that were associated with impaired cognitive control and higher levels of craving video game playing. They also showed increased cortical thickness in the middle temporal cortex, which indicated the acquisition of better skills. Moreover, it was suggested that various factors (eg, gaming expertise, duration or severity of GD, and level of self-control) seemed to modulate the association of extensive video game playing with changes in cognitive function. Conclusions Although a limited number of studies were identified that included pro gamers and/or individuals who reported showing symptoms of GD for more than 1 year, this review contributed to the objective understanding of the association between extensive video game playing and changes in cognitive function. Conducting studies with a longitudinal design or with various comparison groups in the future would be helpful in deepening the understanding of this association.

Effects of Media Multitasking and Video Gaming on Cognitive Functions and Their Neural Bases in Adolescents and Young Adults

“…To find these studies, we used the search terms multitasking / gaming and brain / MRI (MRI refers to magnetic resonance imaging, the most common brain-imaging method) at https://scholar.google.com and then ensured that the studied participants were healthy adolescents or young adults. For example, we excluded studies on individuals with signs of a gaming disorder (for a review of those, see Choi et al, 2021), except for one study (Zhou et al, 2019) that also reports separate results on the effects of gaming in participants with no such problems. In addition, we review findings from research without brain imaging on associations of media multitasking or gaming with cognitive functions.…”

What Constitutes ‘Gaming’ in the Gaming Disorder?: Observations and Recommendations

“… 15 , 35 Six included some description of gaming in the main text. 10 , 15 , 39 , 46 , 47 , 50 These articles referred to e-sports (two articles), 34 , 39 multiplayer online games (one article), 15 AR games (one article), 15 video and/or computer games (five articles), 10 , 15 , 34 , 46 , 50 freemium games (one article), 10 and games that involved microtransactions (one article). 10 One article mentioned that it excluded studies that are exclusively on offline gaming.…”

Video Game Addictive Symptom Level, Use Intensity, and Hedonic Experience: Cross-sectional Questionnaire Study

“…Future research based on longitudinal data can provide information on players and their well-being at different points in time, shedding light on microlevel changes in this relationship. Further, this study does not address cognitive or behavioral consequences of video game play [43]. Lastly, the study relies upon voluntary, self-reported data, which is subject to limitations related to honesty, introspective ability, and sampling (or self-selection) bias.…”